Paediatric Abdominal Surgical Emergencies in Enugu, South East Nigeria: Any Change in Pattern and Outcome
European Journal of Clinical and Biomedical Sciences
Volume 5, Issue 2, April 2019, Pages: 39-42
Received: May 7, 2019;
Accepted: Jun. 10, 2019;
Published: Jun. 26, 2019
Views 151 Downloads 23
Chukwubuike Kevin Emeka, Department of Surgery, Enugu State University Teaching Hospital, Enugu, Nigeria
Nduagubam Obinna Chukwuebuka, Department of Paediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
Ndu Ikenna Kingsley, Department of Paediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
Odetunde Oluwatoyin Arinola, Department of Surgery, Enugu State University Teaching Hospital, Enugu, Nigeria
Ekenze Sebastin Okwuchukwu, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria
Eze Thaddeus Chikaodili, Department of Surgery, Enugu State University Teaching Hospital, Enugu, Nigeria
Follow on us
Background: Paediatric abdominal surgical emergencies (PASE) constitute a significant workload of the paediatric surgeon. The objective of this study was to characterize the pattern of PASE in a tertiary hospital in Enugu and determine any change in pattern and outcome. Methodology: This was a retrospective study of children aged 1 day to 16 years who presented with abdominal surgical emergencies to Enugu State University Teaching Hospital (ESUTH), Enugu. Result: There were 152 patients recruited for the study. There were 122 males and 30 females. The mean age at presentation was 6 years while the mean duration of symptoms before presentation to the hospital was 3.5 days. Thirty eight (25%) patients presented within 48 hours of the onset of their symptoms while 114 patients (75%) presented after 48 hours. The emergencies were intussusception 56 (36.8%), typhoid intestinal perforation 30 (19.7%), obstructed hernia 20 (13.2%), appendicitis 17 (11.2%), abdominal trauma 10 (6.6%), neonatal intestinal obstruction 6 (4%), ruptured appendix 6 (3.9%), Hirschsprung’s disease 4 (2.6%), adhesive bowel obstruction 2 (1.3%), and Gastroschisis 1 (0.7%). The mean hospital stay was 6.7 days. Thirty four patients (22.4%) who had surgery developed post-operative complication. The most common complication was surgical site infection and this occurred most in patients who had typhoid intestinal perforation (P = 0.017). There were 12 (7.9%) deaths. Conclusion: In this series, intussusception was the most common paediatric abdominal surgical emergency seen in Enugu unlike in the past when it used to be typhoid intestinal perforation. Mortality was less in the current study. This illustrates a change in pattern and outcome.
Paediatric, Emergencies, Outcome, Pattern, Abdominal, Change
To cite this article
Chukwubuike Kevin Emeka,
Nduagubam Obinna Chukwuebuka,
Ndu Ikenna Kingsley,
Odetunde Oluwatoyin Arinola,
Ekenze Sebastin Okwuchukwu,
Eze Thaddeus Chikaodili,
Paediatric Abdominal Surgical Emergencies in Enugu, South East Nigeria: Any Change in Pattern and Outcome, European Journal of Clinical and Biomedical Sciences.
Vol. 5, No. 2,
2019, pp. 39-42.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Elhardello OA, MacFie J. Digital rectal examination in patients with acute abdominal pain. Emerg Med J. 2018; 35 (9): 579-580.
Adejuyigbe O, Fashakin EO. Acute intestinal obstruction in Nigerian children. Trop Gastroenterol. 1989; 10: 33-40.
Mhando S, Young B, Lakhoo K. The scope of emergency paediatric surgery in Tanzania. Pediatr Surg Int. 2008; 24: 219-222.
De Burlet K, Lam A, Larsen P, Dennett E. Acute abdominal pain – changes in the way we assess it over a decade. N. Z. Med J. 2017; 130 (1463): 39-44.
Nadia MH, Craig AF. Managing acute abdominal pain in pediatric patients: current perspectives. Pediatric Health, Medicine and Therapeutics. 2017; 8: 83-91.
Abdur-Rahman LO, James OA, Adejuyigbe O. Paediatric surgical abdominal emergencies in a north central Nigerian centre. Annals of Pediatr Surgery. 2012; 8: 25-28.
Mohammed MF, Elbanna KY, Mohammed AME, Murray N, Azzumea F, Almazied G, Nicolam S. Practical Application of Dual-Energy Computed Tomography in the Acute Abdomen. Radiol Clin North Am. 2018; 56 (4): 549-563.
Mai-Phan MA, Patel B, Walsh M, Abraham AT, Kocher HM. Emergency room surgical workload in an inner city UK teaching hospital. World J Emerg Surg. 2008; 3: 19. doi: 10. 1186/1749-7922-3-19.
Abubakar AM, Ofoegbu CP. Factors affecting outcome of emergency pediatric abdominal surgery. Niger J Surg Res. 2003; 3-4: 85-91.
Ekenze SO, Anyanwu PA, Ezomike UO, Oguonu T. Profile of pediatric abdominal surgical emergencies in a developing country. Int Surg. 2010; 95 (4): 319-24.
Ademuyiwa OA, Bode CO, Adesanya OA, Elebute OA. Non- trauma related paediatric abdominal surgical emergencies in Lagos, Nigeria: Epidemiology and indicators of survival. Niger Med J. 2012; 53 (2): 76-79. doi: 10. 4103/0300-1652: 103546.
Uba AF, Edino ST, Yakubu AA, Sheshe AA. Childhood intestinal obstruction in Northwestern Nigeria. West African Journal of Medicine. 2004; 23: 314-18.
Houben CH, Pang KK, Mou WC, Chan KW, Tam YH, Lee KH. Epidemiology of small bowel obstruction beyond the neonatal period. 2016; 12 (3): 90-93. doi: 10. 1097/01.XPS.0000481055.24776.db.
Abantanga FA, Nimako B, Amoah M. The range of abdominal surgical emergency in children older than 1 year at Komfo Anokye Teaching Hospital, Kumasi, Ghana. 2009; 8 (4): 236-242.
Li PH, Tee YS, Fu CY, Liao CH, Wang SY, Hsu YP, Yeh CN, Wu EH. The Role of Nonconstrast CT in the Evaluation of Surgical Abdomen Patients. Am Surg 2018; 84 (6): 1015-1021.
Emily Janitz, Lena Naffaa, Michael Rubin, Srinivas Ganapathy. Ultrasound Evaluation for Appendicitis. Focus on the Pediatric Population: A Review of the Literature. J Am Osteopath Coll Radiol. 2016; 5 (1): 5-14.
Nnabuchi CV, Babalola DI. Incidence and management of typhoid fever in Nigeria. Journal of Obafemi Awolowo University Medical student’s Association (IFEMED). 2008; 14 (1): 75-78.
Antonoff M, Marquez T, Saltzman D. Physiology of the newborn. In: Holcomb GW, Murphy JP, editors. Ashcraft’s Pediatric Surgery. 5th ed. Philadelphia: Saunders Elsevier; 2010.
Si Ra Bang. Neonatal anesthesia; how we manage our most vulnerable patients. Korean J Anesthesiol. 2015; 68 (5): 434-441. doi: 10. 4097/kjae.2015.68.5.434.